The applicability of multiparameter flow cytometry for the detection of minimal residual disease using different-from-normal panels to predict relapse in patients with acute myeloid leukemia after allogeneic transplantation.

Abstract

BACKGROUND:

The MRD status detected using multiparameter flow cytometry (MFC) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) has crucial prognostic value for patients with acute myeloid leukemia (AML) in morphologic complete remission (CR). We designed a novel panel of antibodies to identify aberrant differentiation/maturation profiles of residual leukemia cells in patients who were not diagnosed at our institution, relapsed with an antigenic shift, or lack leukemia-associated immunophenotypes.

METHODS:

We compared the MRD status detected using MFC and real-time quantitative polymerase chain reaction (RT-qPCR) in the same 158 bone marrow samples collected from 44 AML patients carrying leukemia-specific fusion genes. The clinical performance of the MFC-based MRD status was analyzed in 168 AML patients who exhibited morphologic CR (135) or active disease (33) before HSCT.

RESULTS:

Strong concordance was found between MFC-based and RT-qPCR-based MRD status (κ = 0.868). Among the patients displaying CR, the positive MRD status detected using MFC was correlated with a worse prognosis [HRs (P values) for relapse, event-free survival, and overall survival: 4.83 (<0.001), 2.23 (0.003), and 1.79 (0.049), respectively]; the prognosis was similar to patients with an active disease before HSCT. Patients with a positive MRD before HSCT might experience a benefit from developing chronic graft-vs-host disease.

CONCLUSIONS:

The assessment of MRD using our self-built different-from-normal AML-MRD detection panel exhibited reliable sensitivity, specificity, and accuracy. In addition, patients with a positive MRD status before transplantation may have higher risk of relapse and worse survival.

• Authors: Ziwei Wang, Mengqiao Guo, Yuesheng Zhang, Sheng Xu, Hui Cheng, Jiawei Wu, Weiping Zhang, Xiaoxia Hu, Jianmin Yang, Jianmin Wang, Gusheng Tang
• Journal: International journal of laboratory hematology (Int J Lab Hematol) Vol. 41 Issue 5 Pg. 607-614 (Oct 2019) ISSN: 1751-553X [Electronic] England
• PMID: 31162830 (Publication Type: Journal Article)
• Copyright: © 2019 John Wiley & Sons Ltd.

Chemical References

• Oncogene Proteins, Fusion

Topics

• Acute Disease
• Adolescent
• Adult
• Child
• Disease-Free Survival
• Female
• Flow Cytometry (instrumentation, methods)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Immunophenotyping (methods)
• Leukemia, Myeloid (genetics, metabolism, therapy)
• Male
• Middle Aged
• Neoplasm, Residual (diagnosis, genetics)
• Oncogene Proteins, Fusion (genetics)
• Prognosis
• Recurrence
• Reverse Transcriptase Polymerase Chain Reaction
• Transplantation, Homologous
• Young Adult